Burke M T, Trnka P, Walsh M, Poole L, McTaggart S J, Burke J R
Department of Renal Medicine, Nambour General Hospital, Nambour, Qld, Australia.
Pediatr Transplant. 2013 Aug;17(5):E119-24. doi: 10.1111/petr.12107.
PML is a demyelinating disease of the central nervous system caused by infection with JCV. Several cases of PML in bone marrow and solid organ transplant recipients have been reported in recent years. JCV has been isolated from the gastrointestinal mucosa of immunocompromised patients, but there are no published reports of PML associated with symptomatic gastrointestinal involvement in kidney transplant recipients. We report a case of a nine-yr-old girl with a kidney transplant who developed a severe gastrointestinal illness causing pseudo-obstruction in association with PML. JCV was suspected as the causative agent in this patient by the detection of high JCV titer through PCR analysis of the cerebrospinal fluid and blood and positive staining for simian virus 40 in the colon. JCV intestinal infection should be considered in kidney transplant recipients presenting with intestinal pseudo-obstruction.
进行性多灶性白质脑病（PML）是一种由约翰·坎宁安病毒（JCV）感染引起的中枢神经系统脱髓鞘疾病。近年来，已有多例骨髓和实体器官移植受者发生PML的病例报道。JCV已从免疫功能低下患者的胃肠道黏膜中分离出来，但尚无关于肾移植受者出现有症状胃肠道受累相关PML的公开报道。我们报告一例9岁肾移植女孩，其出现严重胃肠道疾病并导致假性肠梗阻，同时伴有PML。通过对脑脊液和血液进行PCR分析检测到高JCV滴度以及结肠中猴病毒40阳性染色，怀疑该患者的病原体为JCV。对于出现肠道假性肠梗阻的肾移植受者，应考虑JCV肠道感染。
